Blood pressure and heart rate variability in elderly hypertensive patients

In elderly hypertensive patients (HP) blood pressure (BP) and heart rate (HR) control and variability seem to be affected by a reduced baroreceptor sensitivity, or autonomic dysfunction, and concomitant cardiovascular diseases. Therefore, the aim of present study was to investigate the circadian profiles and variability of BP and HR, by means of a 24-hour ambulatory BP monitoring, in a group of 22 elderly HP compared with those of a group of 24 middle aged patients with essential hypertension. Many differences in BP and HR profile and variability were observed in elderly HP when compared to those of middle aged HP, such as significantly lower diurnal diastolic BP values. lower nocturnal BP fall, lower diurnal HR but with a greater diurnal variability. Conversely, in middle aged HP a significantly greater diurnal systolic BP variability was observed, and a significant correlation was found between hourly diastolic BP and hourly HR values, while in elderly HP this correlation was not detectable. The changes in BP and HR profile and variability observed in elderly HP may play a role as risk factors for cardiovascular complications and indicate a dysfunction of autonomic and nonautonomic factors in BP control.